Two GOP Lawmakers Back HMO Controls

Goldreich, Samuel, The Washington Times (Washington, DC)

Joining the crackdown on managed-care insurance, prominent Republicans will introduce a catchall bill in Congress tomorrow that would strengthen consumer protection and make it easier for many patients to sue their health plans.

Combined with Democratic backing for similar legislation, the new GOP support should boost the chances for passage of a comprehensive bill to regulate health maintenance organizations (HMOs).

"Our bill in no way mandates any new benefits," said Rep. Charlie Norwood, Georgia Republican, author of the House legislation. "I don't believe we can legislate body part by body part, but we are trying to give patients more control over their health care."

Mr. Norwood failed last year to win committee backing for an earlier version of his bill but he has recruited a powerful co-sponsor in Sen. Alfonse M. D'Amato, New York Republican. GOP leaders yesterday declined comment but health-industry lobbyists say the legislation likely will get a serious hearing under the leadership of Mr. D'Amato, who has emerged as an election-year champion of patients' rights.

While the GOP has blocked many previous efforts to impose federal regulations on managed care, the Norwood bill would guarantee access to emergency care without prior approval and expand choice of doctors for patients willing to pay for the privilege. Many of its provisions are included in bills co-authored by Sen. Edward M. Kennedy, Massachusetts Democrat, and Rep. John D. Dingell, Michigan Democrat.

The GOP legislation follows a national trend of imposing rules of engagement between health plans and their 150 million patients, many of whom complain that quality care is being sacrificed to cost-cutting controls. At least 40 states have passed laws dictating HMO coverage and Congress responded last year by requiring hospital stays of at least 48 hours for new mothers and their babies.

"In the past, consumers have always liked health insurance mandates, which covered things like chiropractic care," said Merrill Matthews, health policy director of the Dallas-based National Center for Policy Analysis, an advocate of free-market health care. "Now, they like these new laws even more because they are seen as protecting them from managed care."

Mr. Norwood's bill already has come under attack from managed-care advocates, who say it does more to protect doctors than to help patients. Proposed limits on a plan's ability to choose which doctors it will sign up effectively would create an "any willing provider" system that would require HMOs to enroll anyone who applies, said Julie Goon, vice president for government affairs at the American Association of Health Plans. …

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